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Tracie L. Miller, M.D.

Professor of Pediatrics

Description of Research

Dr. Miller joined the faculty at the University of Miami in 2003. Dr. Miller has had a number of both NIH grants as well as Foundation awards that study the nutrition, body composition and cardiovascular status (as it relates to atherosclerotic cardiovascular disease risk) in pediatric cancer survivors. Dr. Miller is also studying the effect of a structured physical activity intervention program on metabolic and cardiovascular disease outcomes in pediatric cancer survivors.

Dr. Miller has studied the body composition of pediatric cancer survivors and has determined that survivors, despite having similar BMI’s to their siblings, have greater levels at body fat. This body fat, in turn, was related to receipt of cranial irradiation during their initial treatment as well as their current physical activity level. Furthermore, boys tended to have greater numbers of cardiovascular disease risk factors including higher LDL cholesterols, higher triglycerides and overall total cholesterol. Dr. Miller has also shown that pediatric cancer survivors have decreased exercise capacity as measured by VO2 max testing, when compared to their siblings. Dr. Miller has also assessed bone mineral density of pediatric cancer survivors and has determined that cancer survivors are at risk for low bone mineral density and factors associated with low bone mineral density included low IGF-1 levels and cranial irradiation. Dr. Miller is currently evaluating vascular dysfunction and a physical activity intervention for pediatric cancer survivors and is actively recruiting patients into her studies. In addition, Dr. Miller is a co-investigator on NCI-supported studies that evaluate the role of mitochondrial abnormalities on cardiovascular dysfunction in pediatric cancer survivors.

Highlights

Discovery that there are increased levels of body fat in pediatric cancer survivors, despite the body mass index being similar to controls. Higher levels of body fat are related to cranial irradiation and inactivity. This suggests that these survivors may be at increased cardiovascular disease risk through their increased levels of body fat.

Discovery that male pediatric survivors of childhood cancer have higher levels of lipids that would also place them at a higher cardiovascular disease risk.

Discovery that pediatric cancer survivors have lower exercise capacity than sibling controls. This could also contribute to their greater atherosclerotic cardiovascular disease risk.

Discovery that pediatric cancer survivors have lower bone mineral density than expected; and this was also related to cranial irration and hormone levels.